Wheeled suture passer

ABSTRACT

A suture passer assembly is used for manipulating a suture with a selectively moveable wire member. The suture passer assembly includes at least one grasping member and a single-body hollow tube. The tube defines a first end, a second end, a tube wall, and a tube passage extending from the first end to the second end. The wire member is moveably received within the tube passage. The tube wall includes at least one aperture that is disposed between the first end and the second end. A first portion of the grasping member extends through the tube wall and into the tube passage via the aperture. A second portion of the grasping member remains outside the hollow tube. The first portion is operable to grasp the wire member and selectively move the wire member relative to the hollow tube due to manipulation of the second portion of the grasping member.

FIELD

The present disclosure relates to a wheeled suture passer and, moreparticularly, to a wheeled suture passer for securely advancing a wirefor use as a suture retrieve or other appropriate use.

BACKGROUND

This section provides background information related to the presentdisclosure which is not necessarily prior art.

Damaged anatomical tissue can be repaired using sutures. A typicalsuture can be threaded through two separate areas of tissue, and thesuture can be tied to thereby attach the areas of tissue. As such, theareas of tissue can be held together by the suture and, over time, theareas of tissue can heal together to restore function of the anatomy.These procedures can be used for various surgical procedures, such asrepair of a torn rotator cuff, etc.

Threading the suture through tissue and then tying a knot in the suturecan be difficult, especially when the procedure is performedarthroscopically. This is because the surgeon's view of the area can belimited, because there can be relatively little open space within theanatomy to work, etc. Thus, various suture passers have been proposedfor facilitating these procedures.

SUMMARY

This section provides a general summary of the disclosure, and is not acomprehensive disclosure of its full scope or all of its features.

A suture passer assembly is disclosed that is used for manipulating asuture with a selectively moveable wire member. The suture passerassembly includes at least one grasping member and a single-body hollowtube. The tube defines a first end, a second end, a tube wall, and atube passage extending from the first end to the second end. The wiremember is moveably received within the tube passage. The tube wallincludes at least one aperture that is disposed between the first endand the second end. A first portion of the grasping member extendsthrough the tube wall and into the tube passage via the aperture. Asecond portion of the grasping member remains outside the hollow tube.The first portion is operable to grasp the wire member and selectivelymove the wire member relative to the hollow tube due to manipulation ofthe second portion of the grasping member.

Moreover, a method of selectively moving a portion of a suture from afirst anatomical location to a second anatomical location is disclosed.The method includes inserting a hollow tube of a suture passer assemblyinto a patient toward the first anatomical location and toward theportion of the suture. The hollow tube is a single body defining a firstend, a second end, a tube wall, and a tube passage extending from thefirst end to the second end. A wire member with a gripping end ismoveably received within the tube passage. The tube wall includes atleast one aperture that is disposed between the first end and the secondend. The suture passer assembly also includes at least one graspingmember with a first portion extending through the tube wall and into thetube passage via the at least one aperture. A second portion of the atleast one grasping member remains outside the hollow tube. Additionally,the method includes manipulating the second portion such that the firstportion pushes the gripping end of the wire member out of the hollowtube from the second end. Furthermore, the method includes manipulatingthe second portion such that the first portion pulls the gripping endand the portion of the suture toward the hollow tube to secure theportion of the suture to the suture passer assembly. Moreover, themethod includes moving the portion of the suture to the secondanatomical location using the suture passer assembly.

Still further, a suture passer assembly for manipulating a suture isdisclosed. The suture passer assembly includes a wire member. Theassembly also includes a handle member with a handle passage definedtherethrough and a first wheel and a second wheel that are eachrotatably supported on the handle member. Additionally, the assemblyincludes a single-body hollow tube defining a longitudinal axis, a firstend, a second end, a tube wall, and a tube passage extending from thefirst end to the second end. The hollow tube is received within thehandle passage, and the wire member is moveably received within the tubepassage. The tube wall includes a first slot and a second slot that areeach disposed between the first end and the second end and that aredisposed on opposite sides of the longitudinal axis. The first wheelpartially extends through the first aperture and into the hollow tube,and the second wheel partially extends through the second aperture andinto the hollow tube. The first and second wheels are operable tocooperatively grasp the wire member within the tube passage such thatdriving rotation of at least one of the first wheel and the second wheeladvances the wire member relative to the tube member.

Further areas of applicability will become apparent from the descriptionprovided herein. The description and specific examples in this summaryare intended for purposes of illustration only and are not intended tolimit the scope of the present disclosure.

DRAWINGS

The drawings described herein are for illustrative purposes only ofselected embodiments and not all possible implementations, and are notintended to limit the scope of the present disclosure.

FIG. 1 is an isometric view of a suture passer illustrated according tovarious exemplary embodiments of the present disclosure;

FIG. 2 is an exploded view of the suture passer of FIG. 1;

FIG. 3 is a longitudinal sectional view of a tube of the suture passerof FIG. 1;

FIG. 4 is a longitudinal sectional view of the suture passer of FIG. 1;

FIG. 5 is an isometric view of the suture passer of FIG. 1, wherein aportion of a handle member has been removed; and

FIGS. 6-10 are isometric views of the suture passer of FIG. 1 shownbeing used to pass a suture through anatomical tissue.

Corresponding reference numerals indicate corresponding parts throughoutthe several views of the drawings.

DETAILED DESCRIPTION

Example embodiments will now be described more fully with reference tothe accompanying drawings.

Referring initially to FIGS. 1 and 2, a suture passer assembly 10 isillustrated according to various exemplary embodiments of the presentdisclosure. As will be discussed, the suture passer assembly 10 can beused for manipulating a suture 12 (FIGS. 6-10). More specifically, awire member 14 (FIGS. 7 and 8) can be moveably mounted within the suturepasser assembly 10, and the suture passer assembly 10 can be used toselectively move the wire member 14 for manipulating the suture 12(e.g., for passing the suture 12 through anatomical tissue) as will bediscussed in greater detail below.

As shown in FIGS. 1 and 2, the suture passer assembly 10 can include ahandle member 16. The handle member 16 can include a first portion 18and a second portion 20 that are joined together in a clam-shell orother type of configuration. The handle member 16 can be made of apolymeric or other type of material. The first and second portions 18,20 can cooperate to define a handle end 22 of the handle member 16,which the user (e.g., a surgeon) can comfortably hold in one hand. Thefirst and second portions 18, 20 can also cooperate to define a lead end28 of the handle member 16. The lead end 28 can be frustoconical inshape and can be disposed on an opposite end of the handle member 16from the handle end 22. Moreover, one or both of the first and secondportions 18, 20 can also define a first hub 24 and a second hub 26 (FIG.2). The hubs 24, 26 can be cylindrical and can extend perpendicularlybetween the first and second portions 18, 20, within the handle member16. Additionally, the handle member 16 can define a handle passage 30(FIG. 4) that extends longitudinally therethrough along an axis X. Asshown in FIG. 4, the wire member 14 can be moveably received within thehandle passage 30.

The suture passer assembly 10 can also include at least one graspingmember 32 a, 32 b that are operable to selectively grasp and advance thewire member 14 relative to the handle member 16 and other portions ofthe assembly 10. In the embodiments illustrated, there are two graspingmembers 32 a, 32 b that are embodied as a first wheel 34 and a secondwheel 35, respectively. However, it will be appreciated that there couldbe a single grasping member 32 a, 32 b or any other number of graspingmembers 32 a, 32 b without departing from the scope of the presentdisclosure. Moreover, the grasping members 32 a, 32 b could be embodiedin ways other than the wheels 34, 35 (e.g., such as levers, sliders,etc.) without departing from the scope of the present disclosure.

The wheels 34, 35 can both be cylindrical and can both include an outerdiameter surface 36. Also, the outer diameter surface 36 can be definedby sets of teeth 38 (cogs, radial projections, etc.). The teeth 38 canhave a generally triangular profile as shown in FIG. 5, but the teeth 38can have any suitable grippable or engageable shape. The outer diametersurface 36 can also be defined by a compressible member 40 of therespective wheel 34, 35. The compressible member 40 can be made from acompressible, but relatively high friction material, such as rubber,foam, etc. However, the member 40 can be substantially incompressibleand rigid in some embodiments as well. Also, in the embodiments shown inFIG. 5, the compressible member 40 can be an annular band that isdisposed longitudinally between the sets of teeth 38 of the respectivewheel 34, 35.

The wheels 34, 35 can be rotationally supported on the hubs 24, 26,respectively (FIG. 4). As such, the wheels 34, 35 can rotate aboutrespective rotational axes R1, R2 relative to the handle member 16.

As will be discussed, the compressible member 40 can abut andfrictionally engage the wire member 14. Thus, rotation of the wheels 34,35 about the axes R1, R2 can advance (i.e., push or pull) the wiremember 14 within the assembly 10.

Also, the wheels 34, 35 can be mounted such that the set of teeth 38 ofthe first wheel 34 can meshingly engage the set of teeth 38 of thesecond wheel 35. Accordingly, the user can drivingly rotate only onewheel 34, 35 to thereby drivingly rotate the other wheel 34, 35 foradded convenience and improved ergonomics.

It will be appreciated that the outer diameter surface 36 can includeradial projections having shapes, spacing, etc. other than those of theillustrated teeth 38 for meshingly engaging the wheels 34, 35.Additionally, in some embodiments, the outer diameter surfaces 36 can besmooth such that the wheels 34, 35 do not meshingly engage. Otherwise,in some embodiments, the outer diameter surfaces 36 can be smooth andcan frictionally engage each other so that the wheels 34, 35 canrotatably drive each other.

Furthermore, the assembly 10 can include a hollow tube 42. The hollowtube 42 can be a monolithic body (i.e., single body, uni-bodyconstruction, etc.). The tube 42 can be constructed from metal orpolymer. The tube 42 can also extend along the longitudinal axis X. Asshown in FIGS. 2 and 3, the tube 42 can define a first end 44, a secondend 46, and a tube wall 48. The first end 44 and much of the second end46 can be axially straight; however, terminal portions of the second end46 can axially curve as shown in FIGS. 1 and 2. The second end 46 canalso include sharpened edges such that the second end 46 can be used forcutting anatomical tissue as will be discussed.

The tube wall 48 can define an inner tube surface 50 and an outer tubesurface 52 as shown in FIG. 3. Moreover, a tube passage 53 can extendlongitudinally along the axis X through the tube 42. The tube passage 53can extend continuously along the tube 42 between the first end 44 andthe second end 46. As will be discussed, the wire member 14 can bemoveably received within the tube passage 53.

The tube 42 can be fixedly attached and supported by the handle member16. More specifically, the first and second portions 18, 20 of thehandle member 16 can be attached such that the first end 44 of the tube42 is enclosed within the handle passage 30 and sandwiched between thefirst and second portions 18, 20 of the handle member 16. As shown inFIGS. 2 and 4, the tube wall 48 can include one or more orientationopenings 59 (e.g., slots) that receive complementary projections of thefirst and/or second portions 18, 20 for further securing the tube 42 tothe handle member 16. Adhesives, fasteners, or other means canadditionally be used for securing the tube 42 to the handle member 16.With the first end 44 secured to the handle member 16, the second end 46of the tube 42 can extend out from and can be exposed from the handlemember 16.

As shown in FIGS. 2-5, the tube wall 48 can include at least oneaperture 54. The aperture 54 can be disposed between the first andsecond ends 44, 46 of the tube 42. In the embodiments illustrated inFIGS. 3 and 4, the tube wall 48 includes two apertures 54 that areembodied as respective elongate slots 56, 58. The slots 56, 58 canextend radially through both the inner tube surface 50 and the outertube surface 52. Also, the slots 56, 58 can extend substantiallyparallel to the axis X and can be disposed symmetrically on oppositesides of the axis X. As shown in FIG. 3, the slots 56, 58 can taperoutward from the inner tube surface 50 to the outer tube surface 52.However, it will be appreciated that the tube 42 can include any numberof apertures 54, and the aperture(s) 54 can have any suitable shape andany suitable position on the tube wall 48.

As shown in FIG. 4, a first portion 60 of each wheel 34, 35 can bereceived within the slots 56, 58, respectively. Specifically, the firstportion 60 is defined at an inner radial segment of the compressiblemember 40 as the wheels 34, 35 rotate. These first portions 60 extendthrough the tube wall 48 and radially into the tube passage 53 via therespective slot 56, 58. The slots 56, 58 can be shaped and sized suchthat the first portion 60 substantially fills the entire respective slot56, 58. The remaining portions (i.e., second portions 62) remain outsidethe tube 42. The second portion 62 can be defined on the outer radialportions of the compressible members 40. Also, each of the sets of teeth38 can remain outside the tube 42 because the teeth 38 are spaced awayon either side of the respective compressible members 40 (along therespective rotational axis R1, R2). Also, the handle member 16 caninclude openings 63 (FIGS. 1 and 4) that partially expose the respectivesecond portions 62 of the wheels 34, 35 so that the user can contact thewheels 34, 35.

As shown in FIG. 2, the wire member 14 can be a continuous, flexiblewire having a proximal end 64 and a distal end 66. The wire member 14can be made from Nitinol, a polymer or other suitable material. Thedistal end 66 can include a diamond-shaped loop 68. The loop 68 can beresiliently compressible. Also, in some embodiments, the distal end 66can include opposed pinchers, a hook, or other devices. The wire member14 can be moveably received within the handle passage 30 and the tubepassage 53. Specifically, to load the wire member 14, the wire member 14can be inserted into the handle passage 30 defined by the handle end 22and advanced along the axis X toward the tube 42. Since the tube passage53 is coaxial with the handle passage 30, the wire member 14 can advanceeasily into the first end 44 of the tube 42 and advance between thewheels 34, 35 as shown in FIG. 4. Then, the wheels 34, 35 can be rotatedto further advance the distal end 66 toward the second end 46 of thetube 42.

It will be appreciated that the distal end 66 of the wire member 14 canbe relatively easily and conveniently advanced toward the second end 46of the tube 42. This is because the tube 42 is monolithic (i.e., singlebody, uni-body, etc.), because the opening 59 is blocked by the handlemember 16, and because the slots 56, 58 are blocked by the firstportions 60 of the wheels 34, 35. As such, the wire member 14 has littleor no ability to advance out of the tube 42 until the distal end 66reaches the second end 46 of the tube 42. Accordingly, the suture passerassembly 10 can be prepared for use relatively quickly and conveniently.

Moreover, once the wire member 14 is loaded within the assembly 10, theloop 68 can be selectively advanced out and retracted into the secondend 46 of the tube 42. This can be accomplished by drivingly rotatingthe wheels 34, 35. As mentioned above, the user can apply force to onlyone wheel 34, 35 and because the wheels 34, 35 are meshingly engaged,both wheels 34, 35 can advance the wire member 14 for added convenience.

FIGS. 6-10 illustrate exemplary uses of the suture passer assembly 10.In some embodiments, the suture passer assembly 10 can be used to repaira damaged rotator cuff; however, it will be appreciated that the suturepasser assembly 10 can be used for repairing any anatomical feature.Also, the assembly 10 can be used arthroscopically in some embodiments.

As shown in FIG. 6, the suture 12 can include an anchor 71 that can beanchored (e.g., threaded) into a first anatomical feature 74 (e.g., bonetissue). The suture 12 can also include two flexible ties 72 a, 72 bthat extend from the anchor. Thus, one or more incisions (not shown) canbe made in the patient's skin, and the anchor 71 can be fixed to thefirst anatomical feature 74. The ties 72 a, 72 b can be initially untiedas shown in FIG. 6.

Next, an opening, such as a piercing or an incision 78 can be made in asecond anatomical feature 76 (e.g., soft tissue such as a torn rotatorcuff). The incision 78 can be in communication with one or more otherincisions formed within the patient's skin. The incision 78 can be madedirectly by the sharpened edges of the second end 46 of the tube 42.Alternatively, the incision 78 can be made using another cutting tool.Also, a cannula (not shown) can be inserted into the incision 78 and thesecond end 46 of the tube 42 can be advanced through the incision 78 viathe cannula.

Once the second end 46 has been inserted through the incision 78 (FIGS.6 and 7), the wheels 34, 35 can be rotated in a first direction toadvance the loop 68 out of the second end 46 (FIG. 7). The loop 68 canbias open to a width that is larger than that of the second end 46.

Then, as shown in FIG. 8, a tool 73 can be inserted into the patient(e.g., through an incision that is not shown), and the tool 73 can beused to grab one of the ties 72 a and advance the tie 72 a into the loop68 as indicated by the arrow in FIG. 8.

Once the tie 72 a has been received in the loop 68, the wheels 34, 35 ofthe suture passer assembly 10 can be rotated in a second direction toretract the loop 68 back into the second end 46. Specifically, as theloop 68 retracts, the loop 68 can resiliently flex to close around thetie 72 a. Thus, the tie 72 a can be restrained and captured within theloop 68 and/or restrained between the loop 68 and the inner tube surface50 of the tube 42 as shown in FIG. 9.

Once the tie 72 a is restrained, the surgeon can pull the assembly 10back through the incision 78, thereby pulling the tie 72 through theincision. Subsequently, the ties 72 a, 72 b can be tied in one or moreconventional knots to thereby attach the first and second anatomicalfeatures 74, 76 together.

Accordingly, the suture passer assembly 10 can allow the user toconveniently load the wire member 14 therein. Also, the suture passerassembly 10 can allow the user to comfortably and accurately controladvancement of the wire member 14 within the tube 42. As a result, theuser can more quickly and efficiently perform surgical procedures usingsutures 12.

The foregoing description of the embodiments has been provided forpurposes of illustration and description. It is not intended to beexhaustive or to limit the disclosure. Individual elements or featuresof a particular embodiment are generally not limited to that particularembodiment, but, where applicable, are interchangeable and can be usedin a selected embodiment, even if not specifically shown or described.The same may also be varied in many ways. Such variations are not to beregarded as a departure from the disclosure, and all such modificationsare intended to be included within the scope of the disclosure.

What is claimed is:
 1. A suture passer assembly for manipulating asuture with a selectively moveable wire member, the suture passerassembly comprising: at least one grasping member; and a single-bodyhollow tube having a tube wall extending from a first end to a secondend and defining a tube passage extending from the first end to thesecond end, the wire member moveably received within the tube passage,the tube wall including at least one aperture extending through the tubewall to the tube passage that is disposed between the first end and thesecond end, a first portion of the at least one grasping memberextending through the tube wall and into the tube passage via the atleast one aperture, a second portion of the at least one grasping memberremaining outside the hollow tube, the first portion operable to graspthe wire member and selectively move the wire member relative to thehollow tube due to manipulation of the second portion of the at leastone grasping member.
 2. The suture passer assembly of claim 1, furthercomprising a handle member, the handle moveably supporting the at leastone grasping member and operably supporting the hollow tube.
 3. Thesuture passer assembly of claim 1, wherein the handle member enclosesthe first end of the hollow tube and wherein the second end of thehollow tube is exposed from the handle member.
 4. The suture passerassembly of claim 1, wherein the at least one grasping member comprisesa first grasping member and a second grasping member, wherein the atleast one aperture comprises a first aperture and an opposed secondaperture extending through the tube wall to the tube passage, whereinthe first grasping member is received within the first aperture and thesecond grasping member is received within the opposed second aperture,the first and second grasping members being operable to cooperativelyand selectively move the wire member relative to the hollow tube.
 5. Thesuture passer assembly of claim 4, wherein the hollow tube defines alongitudinal axis, and wherein the first aperture and the secondaperture are substantially symmetrical with respect to each other onopposites sides of the longitudinal axis.
 6. The suture passer assemblyof claim 1, wherein the at least one grasping member includes a wheelthat is rotationally supported relative to the hollow tube.
 7. Thesuture passer assembly of claim 6, wherein the wheel includes acompressible member, the compressible member being received within theat least one aperture.
 8. The suture passer assembly of claim 1, whereinthe at least one grasping member includes a first wheel and a secondwheel that cooperate to selectively move the wire member relative to thehollow tube, the first wheel including a first set of radialprojections, the second wheel including a second set of radialprojections, the first and second sets of radial projections beingconfigured to cooperatively engage one another such that rotation of oneof the first and second wheels drives the other of the first and secondwheels.
 9. The suture passer assembly of claim 8, wherein the firstwheel is operable to rotate about a first rotational axis and the secondwheel is operable to rotate about a second rotational axis, the firstportion of the first wheel being spaced away from the first set ofradial projections along the first rotational axis, the first portion ofthe second wheel being spaced away from the second set of radialprojections along the second rotational axis, the first and second setof radial projections being disposed outside the hollow tube.
 10. Thesuture passer assembly of claim 1, wherein the hollow tube defines alongitudinal axis, and wherein the at least one aperture is a slot thatextends longitudinally substantially parallel to the longitudinal axis.11. The suture passer assembly of claim 10, wherein the tube wallincludes an outer tube surface and an inner tube surface, wherein theslot tapers outward from the inner tube surface to the outer tubesurface.
 12. The suture passer assembly of claim 1, further comprisingthe wire member.
 13. A suture passer assembly for manipulating a suturewith a selectively moveable wire member, the suture passer assemblycomprising: at least one grasping member; and a single-body hollow tubehaving a tube wall extending from a first end to a second end anddefining a tube passage extending from the first end to the second end,the wire member moveably received within the tube passage, the tube wallincluding at least one aperture extending through the tube wall to thetube passage that is disposed between the first end and the second end,a first portion of the at least one grasping member extending throughthe tube wall and into the tube passage via the at least one aperture, asecond portion of the at least one grasping member remaining outside thehollow tube, the first portion operable to grasp the wire member andselectively move the wire member relative to the hollow tube due tomanipulation of the second portion of the at least one grasping member,wherein the hollow tube is curved at the second end, and wherein thesecond end includes a sharpened edge.
 14. A suture passer assembly formanipulating a suture, the suture passer assembly comprising: a wiremember; a grasping member having a first wheel and a second wheel thatare each rotatable; and a single-body hollow tube having a tube wallthat extends substantially along a longitudinal axis from a first end toa second end and defining a tube passage extending from the first end tothe second end, the wire member moveably received within the tubepassage, the tube wall including a first slot and a second slot that areeach disposed between the first end and the second end and that aredisposed on opposite sides of the longitudinal axis, each slot extendingthrough the tube wall to the tube passage, the first wheel partiallyextending through the first slot and into the hollow tube, the secondwheel partially extending through the second slot and into the hollowtube, the first and second wheels operable to cooperatively grasp thewire member within the tube passage such that driving rotation of atleast one of the first wheel and the second wheel advances the wiremember relative to the tube.
 15. The suture passer assembly of claim 14,wherein the first wheel includes a first set of radial projections,wherein the second wheel includes a second set of radial projections,and the first and second sets of radial projections are meshinglyengaged such that rotation of one of the first and second wheelsrotatably drives the other of the first and second wheels.
 16. Thesuture passer assembly of claim 14, wherein both the first and secondwheels includes a compressible member that resiliently compressesradially when grasping the wire member.
 17. The suture passer assemblyof claim 14, wherein the first slot and first wheel are disposedsubstantially symmetrically about the longitudinal axis relative to thesecond slot and the second wheel.
 18. The suture passer assembly ofclaim 14, wherein the tube wall includes an outer tube surface and aninner tube surface, wherein the first slot tapers outward from the innertube surface to the outer tube surface, and wherein the second slottapers outward from the inner tube surface to the outer tube surface.19. The suture passer assembly of claim 14, further comprising a handlemember, the handle member movably supporting the first wheel and thesecond wheel relative to the hollow tube.
 20. The suture passer assemblyof claim 19, wherein the handle member encloses the first end of thehollow tube and wherein the second end of the hollow tube is exposedfrom the handle member.
 21. The suture passer assembly of claim 14,wherein the hollow tube is curved at the second end, and wherein thesecond end includes a sharpened edge.
 22. The suture passer assembly ofclaim 14, wherein the first wheel is operable to rotate about a firstrotational axis and the second wheel is operable to rotate about asecond rotational axis, a portion of the first wheel partially extendingthrough the first slot being spaced away from the first set of radialprojections along the first rotational axis, a portion of the secondwheel partially extending through the second slot being spaced away fromthe second set of radial projections along the second rotational axis,the first and second set of radial projections being disposed outsidethe hollow tube.